The term short stature describes height that is in the third percentile as compared to that of the average height for a person's age, sex, and racial group.
Short stature is generally broken down into three subgroups: familial short stature, constitutional delay and development, and that caused by chronic disease. Familial short stature usually does not require doctor’s care. However, if short stature is related to growth hormone deficiency, the child will need to be treated before reaching puberty to achieve his/her maximum height potential.
Expected Growth (Shadow) and Short Stature
Several factors contribute to short stature, including:
- Genetic factors (eg, skeletal dysplasias, Turner syndrome]]> , ]]>Down’s syndrome]]> , Silver Russell syndrome)
- Endocrine disorders (eg, ]]>hypothyroidism]]> , growth hormone deficiency)
- Delayed puberty (causes temporary short stature, but normal height is eventually achieved)
- Early puberty
- Malnourishment (on a global scale, this is the most common cause of growth failure and is generally associated with poverty)
- Congenital heart disease
- Kidney diseases
- ]]>Sickle cell anemia]]>
- Gastrointestinal disorders (eg, ]]>inflammatory bowel disease]]> )
- Lung conditions ( ]]>cystic fibrosis]]> , severe ]]>asthma]]> , ]]>chronic obstructive pulmonary disease]]> )
A risk factor is something that increases your chance of getting a disease or condition. Some risk factors for short stature are:
- Having family members with short stature
- Poor diet
- Certain diseases and drugs taken by a pregnant woman will increase risk to the newborn child
Contact your child’s pediatrician if you notice a significant decrease in his or her growth rate compared to siblings or friends of similar age, or if your child has stopped growing.
Symptoms vary depending on the type of condition. Children with familial short stature do not have any disease-related symptoms and will typically reach a height similar to that of their parents.
Children who have delayed puberty, “late bloomers”, typically have a close relative with this history and will eventually catch up to their peers in height.
Some symptoms may indicate a medical condition causing short stature. These may include:
- Stopped or dramatically slowed growth (below the third percentile as determined by your doctor)
- Weight loss or gain (more than five pounds in a month)
- Poor nutrition
- Loss of appetite
- Chronic abdominal pain and diarrhea]]>
- Persistent fever
- Chronic headaches and/or vomiting
- Delayed puberty (no spotting by age 15 for a girl or no enlargement of the testes by age 14-15 for a boy)
Your child’s pediatrician will ask about symptoms and medical history. He or she will perform a physical exam to determine height, weight, body proportion (sitting height, trunk-limb proportion), and an exam of craniofacial (skull and face) features.
Tests may include:
- Bone age: an x-ray to determine the chronological age of your child’s bones
- To check for hypothyroidism–thyroxine (T4) and thyroid-stimulating hormone (TSH)
- To check growth hormone levels–insulin-like growth factor-1 (IGF-1) and IGF-binding protein-3 (IGFBP-3)
- A complete blood count to check for blood diseases
- A genetic exam to detect chromosomal abnormalities and to exclude Turner syndrome (a common cause of short stature in girls)
Treatment depends on the cause of short stature. Children with familial short stature do not require treatment.
Surgery may be necessary if the cause of growth hormone deficiency is a brain tumor, a rare possibility.
Short stature cannot be prevented in children who have a familial short stature or those who have a chronic disease. However, in some cases, you can minimize your child’s risk of developing short stature by making sure the child eats a nutritious diet.
Parents can minimize the risk of short stature in their children by eating a nutritious diet during pregnancy and avoiding nonprescription drugs and unsafe sex.
Complications to the condition can be prevented and/or treated if identified early with prenatal testing.
Little People of America (LPA), Inc.
Human Growth Foundation
International Skeletal Dysplasia Registry
Cedars-Sinai Medical Center
The Magic Foundation
BC Health Guide, British Columbia Ministry of Health
Society for Short Stature
Consensus guidelines for the diagnosis and treatment of growth hormone (GH) deficiency in childhood and adolescence: summary statement of the GH Research Society. GH Research Society website. J Clin Endocrinol Metab . 2000; 85(11): 3990-3.
Guyda HJ. Four decades of growth hormone therapy for short children: what have we achieved? J Clin Endocrinol Metab . 1999; 84(12): 4307-6.
Ho NC, Francomano CA. Latest developments in skeletal dysplasias. Am J Med Genet . 2001; 106(4).
Lee PA, Chernausek SD, Hokken-Koelega ACS, et al. International Small for Gestational Age Advisory Board Consensus Development Conference Statement: Management of Short Children Born Small for Gestational Age. April 24-October 1, 2001. Pediatrics . 2003; 111(6):1253-1261.
Little People of America (LPA), Inc. website. Available at: ]]>www.lpaonline.org]]> . Accessed September 2005.
The Magic Foundation website. Available at: ]]>www.magicfoundation.org]]> . Accessed September 2005.
Last reviewed November 2008 by ]]>John C. Keel, MD]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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